| Stillwater Family Therapy Group, Inc. | |
|
4727 W 164th St Lawndale CA 90260-2824 | |
| (310) 378-2520 | |
| Not Available |
| Full Name | Stillwater Family Therapy Group, Inc. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4727 W 164th St, Lawndale, California |
| Authorized Official Name and Position | Virginia Green (CEO) |
| Authorized Official Contact | 3103782520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stillwater Family Therapy Group, Inc. 4727 W 164th St Lawndale CA 90260-2824 Ph: (310) 378-2520 | Stillwater Family Therapy Group, Inc. 4727 W 164th St Lawndale CA 90260-2824 Ph: (310) 378-2520 |
| NPI Number | 1366102337 |
|---|---|
| Provider Enumeration Date | 12/17/2021 |
| Last Update Date | 12/17/2021 |
| Certification Date | 12/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366102337 | NPI | - | NPPES |
| 11702210 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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